Spinal Cord Injury

Spinal cord injury (SCI) is an important contributing factor to morbidity and mortality in the U.S.

Spinal cord trauma can be caused by any number of injuries to the spine. They can result from motor vehicle accidents, falls, sports injuries (particularly diving into shallow water), industrial accidents, gunshot wounds, assault, and other causes.

A minor injury can cause spinal cord trauma if the spine is weakened (such as from rheumatoid arthritis or osteoporosis) or if the spinal canal protecting the spinal cord has become too narrow (spinal stenosis) due to the normal aging process.

Direct injury, such as cuts, can occur to the spinal cord, particularly if the bones or the disks have been damaged. Fragments of bone (for example, from broken vertebrae, which are the spine bones) or fragments of metal (such as from a traffic accident or gunshot) can cut or damage the spinal cord.

Direct damage can also occur if the spinal cord is pulled, pressed sideways, or compressed. This may occur if the head, neck, or back are twisted abnormally during an accident or injury.

Bleeding, fluid accumulation, and swelling can occur inside the spinal cord or outside the spinal cord (but within the spinal canal). The accumulation of blood or fluid can compress the spinal cord and damage it.

A spinal cord trauma is a medical emergency requiring immediate treatment to reduce the long-term effects. The time between the injury and treatment is a critical factor affecting the eventual outcome.

How well a person does depends on the level of injury. Injuries near the top of the spine result in more extensive disability than do injuries low in the spine.

Recovery of some movement or sensation within 1 week usually means the person has a good chance of recovering more function, although this may take 6 months or more. Losses that remain after 6 months are more likely to be permanent.

Routine bowel care frequently takes one hour or more on a daily basis.

A majority of people with spinal cord injury must perform bladder catheterization from time to time.

Modifications of the person's living environment are usually required.

Most people with spinal cord injury are wheelchair- or bed-bound, or have impaired mobility requiring a variety of assistive devices.